The present inventors and others have filed several generally relevant prior applications, including Ser. No. 61/321,212, filed Apr. 6, 2012, Ser. No. 13/064,644, filed Apr. 5, 2011, now U.S. Pat. No. 8,894,594, Ser. No. 13/694,621, filed Dec. 18, 2012, now U.S. Pat. No. 9,044,306, and Ser. No. 14/106,300, filed Dec. 13, 2013. Priority from these prior applications is not being claimed at the initial filing of this application, although applicant reserves the right to later claim priority therefrom if deemed necessary.
Of the above, Ser. No. 14/106,300 is the most recent, and the most relevant to the present invention. Ser. No. 14/106,300 discloses a joint brace with an adjustable ROM stop, as does this application. The adjustable ROM stop of the present invention, and the joint brace employing it, are novel and unobvious over that shown by Ser. No. 14/106,300.
More specifically, FIGS. 33-36 of Ser. No. 14/106,300 disclose a joint brace, optimized to support the fetlock of a horse, incorporating a ROM stop as well as resilient members adapted to add to the ability of the horse's joint structure to support it as the joint moves in extension. FIG. 37 discloses the ROM stop without the resilient members. The ROM stop of the present invention is likewise useful in connection with joint braces both with and without resilient members.
For convenience, FIGS. 33-37 of Ser. No. 14/106,300 (published as application 2014/0148746) are reproduced in this application as FIGS. 1-5, respectively. The text describing these is reproduced below, with the figure numbers corrected accordingly, as follows:
“FIGS. 1-3 show a further refinement, employing the same structure as explained above with respect to FIGS. 31 and 32, but incorporating as well a range of motion (ROM) stop. Limiting the range of motion of the joint can be helpful in rehabilitation of musculoskeletal structures—again, both hard and soft tissues—after injury or surgery. Early return to function is pivotal to the patient's successful recovery from injury. Some early range of motion exercises help attenuate adhesive scar tissue formation, promote more normal tissue formation, and thereby increase functionality. Muscle atrophy is also less than would occur if the lower limb was completely immobilized. However, unrestricted exercise is counterproductive, setting the stage for reinjury or new lesion formation and a more prolonged and possibly unsuccessful outcome. Adjustment of the ROM to optimize it to the patient's specific recovery status is desirable; generally, as the patient recovers, the ROM can be gradually increased.
“This is accomplished in the embodiment shown by providing a ROM stop member 216, held to pin 204 (FIG. 4) by a screw 220. As shown by the exploded view of FIG. 1, a gear wheel 218 having external teeth 218a is keyed to the lower cuff 202. The ROM stop member 216 has internal gear teeth (not shown) which mate with the external teeth of gear wheel 218. The mating internal and external peripheral teeth shown could be replaced with radial teeth on the mating faces of the ROM stop member 216 and the lower cuff 202. ROM stop member 216 also comprises an arm 216a, which is arranged to bear against stop 214 on the upper cuff 200. Thus, as the joint is extended, ROM stop member 216 rotates along with lower cuff 202 until arm 216a contacts stop 214, limiting the ROM of the joint. As the patient recovers, and increased ROM becomes desirable, the relative position of ROM stop member 216 with respect to lower cuff 202 can be adjusted simply by removing screw 220, removing ROM stop member 216 sufficiently to disengage the teeth from one another, turning it counterclockwise and replacing it in its new position.
“There are numerous alternative designs for the ROM stop that will occur to those of skill in the art, and are to be considered within the scope of the invention. These include a non-extensible cord, extending between the fixing points of the resilient tension member 212, and of length appropriate to limit the ROM as desired. Adjustment of ROM could be provided by use of cords of different lengths, or providing a choice of fixing points that would provide differing effective lengths. The cord could also be provided in the form of a tubular length of webbing, possibly encasing the resilient tension member 212. Other alternatives include a plate affixed to the upper cuff 200 in the approximate position of stop 214, with a number of holes for receiving a stop pin that would bear against a block on lower cuff 202; by provision of a number of holes for the stop pin, the ROM could be adjusted.
“It is also desirable to provide adjustment of the tension exerted by the resilient tension member 212; for example, as the joint recovers from injury or surgery, it may be desirable to gradually reduce the tension exerted for a given degree of joint flexion. This can be accomplished in a variety of ways. For example, one or more of the flat ribbons 212c of the resilient tension member 212 can simply be cut away. Different resilient tension members 212 having different characteristics can be employed, or multiple resilient tension members 212 can be employed initially, and be removed progressively as the joint recovers. The attachment point of the resilient tension member 212 on either upper cuff 200 or on wing member 210 can be varied, as can the design of the wing member 210; if the wing member 210 is effectively lengthened, e.g., by proving multiple attachment points along its length, more tension will be exerted for a given degree of joint extension. Likewise, the point at which the resilient tension member 212 begins to exert tension and support the joint can be varied as desired by variation of the geometry of the device.
“It will also be appreciated by those of skill in the art that the function of resilient tension member 212 could be provided by other types of devices, such as tension, compression, leaf, hairpin or torsion springs. The cord containing a dilatant material discussed above with respect to FIG. 16 could also be employed. These are to be considered within the meaning of “resilient tension member” except where the context or explicit language excludes such alternative devices.
“It is also within the scope of the invention that the device could also be made such that the resilient tension members on either side of the brace could be adjusted independently of one another. For example, it may be desirable to provide more tension on one side than the other when the injury is asymmetric.
“As noted, the embodiment of FIGS. 31 and 32 includes the resilient tension member for assistance in bearing the tensile loads on the tendons, while the embodiments of FIGS. 1-3 add to this the ROM stop feature. It is also within the scope of the invention to provide the ROM stop feature without the resilient tension member; this could also be useful in rehabilitation. FIG. 5 shows modification of the device shown to include the ROM stop only. As illustrated, again a ROM stop member 216 is secured to the lower cuff by an arrangement allowing adjustment of their relative radial positions. ROM stop member 216 comprises an arm 216a arranged to bear against a stop 214 secured to the upper cuff 200.”
Thus, as indicated above, Ser. No. 14/106,300 discloses a joint support incorporating a ROM stop. The present application does so as well, but incorporates further improvements in the ROM stop.